The Use of Wearable Sensors and Machine Learning Methods to Estimate Biomechanical Characteristics During Standing Posture or Locomotion: A Systematic Review.

Balance deficits are present in a variety of clinical populations and can negatively impact quality of life. The integration of wearable sensors and machine learning technology (ML) provides unique opportunities to quantify biomechanical characteristics related to balance outside of a laboratory setting. This article provides a general overview of recent developments in using wearable sensors and ML to estimate or predict biomechanical characteristics such as center of pressure (CoP) and center of mass (CoM) motion. This systematic review was conducted according to PRISMA guidelines. Databases including Scopus, PubMed, CINHAL, Trip PRO, Cochrane, and Otseeker databases were searched for publications on the use of wearable sensors combined with ML to predict biomechanical characteristics. Fourteen publications met the inclusion criteria and were included in this review. From each publication, information on study characteristics, testing conditions, ML models applied, estimated biomechanical characteristics, and sensor positions were extracted. Additionally, the study type, level of evidence, and Downs and Black scale score were reported to evaluate methodological quality and bias. Most studies tested subjects during walking and utilized some type of neural network (NN) ML model to estimate biomechanical characteristics. Many of the studies focused on minimizing the necessary number of sensors and placed them on areas near or below the waist. Nearly all studies reporting RMSE and correlation coefficients had values <15% and >0.85, respectively, indicating strong ML model estimation accuracy. Overall, this review can help guide the future development of ML algorithms and wearable sensor technologies to estimate postural mechanics.